Weight gain with insulin therapy

The development of inhaled insulin must be seen in the light of a substantial resistance to insulin therapy in patients with type 2 diabetes and physicians who care for the patients. The reasons for this resistance include anticipated pain, inconvenience, fear of hypoglycaemia and weight gain [55,56]. 

Yki-Jarvinen H, Nikkila K, Makimattila S. Metformin prevents weight gain by reducing dietary intake during insulin therapy in patients with type 2 diabetes mellitus. Drugs 1999 58(Suppl. l) 53-54. 

Although most patients with type 2 diabetes are expected to ultimately require insulin to control their disease, combination with oral medications may obviate the need for nonphysiologically large doses of insulin. This combination may improve glycemic control as well as minimize many of the undesirable side effects of insulin therapy, including weight gain and hyperinsulinemia (126). 

Combining metformin with insulin therapy has been shown to result in less weight gain and better glycemic control with lower insulin requirements Continue combination oral agent therapy + sulfonylurea... 

De Leeuw I, Vague P, Selam JL, Skeie S, Lang H, Draeger E, Elte JW. Insulin detemir used in basal-bolus therapy in people with type 1 diabetes is associated with a lower risk of nocturnal hypoglycaemia and less weight gain over 12 months in comparison to NPH insulin. Diabetes Obes Metab 2005 7(l) 73-82. 

Taken together, those data snggest that the relevance of body weight gain in response to therapy with insulin secretagogues may have been overestimated even when nsing older SUs [9]. 

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